The Nature and Determinants of Neuropsychological Functioning in Late-LifeDepression
Abstract
CONTEXT: Cognitive impairment in late-life depression (LLD) is highly prevalent, disabling, poorly understood, and likely related to long-term outcome. OBJECTIVES: To determine the characteristics and determinants of neuropsychological functioning LLD. DESIGN: Cross-sectional study of groups of LLD patients and control subjects. SETTING: Outpatient, university-based depression research clinic. PARTICIPANTS: One hundred patients without dementia 60 years and older who met DSM-IV criteria for current episode of unipolar major depression (nonpsychotic) and 40 nondepressed, age- and education-equated control subjects. MAIN OUTCOME MEASURES: A comprehensive neuropsychological battery. RESULTS: Relative to control subjects, LLD patients performed poorer in all cognitive domains. More than half exhibited significant impairment (performance below the 10th percentile of the control group). Information processing speed and visuospatial and executive abilities were the most broadly and frequently impaired. The neuropsychological impairments were mediated almost entirely by slowed information processing (beta =.45-.80). Education (beta =.32) and ventricular atrophy (beta =.28) made additional modest contributions to variance in measures of language ability. Medical and vascular disease burden, apolipoprotein E genotype, and serum anticholinergicity did not contribute to variance in any cognitive domain. CONCLUSIONS: Late-life depression is characterized by slowed information processing, which affects all realms of cognition. This supports the concept that frontostriatal dysfunction plays a key role in LLD. The putative role of some risk factors was validated (eg, advanced age, low education, depression severity), whereas others were not (eg, medical burden, age at onset of first depressive episode). Further studies of neuropsychological functioning in remitted LLD patients are needed to parse episode-related and persistent factors and to relate them to underlying neural dysfunction.
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Generalized psychomotor slowing can impact performance across several cognitive processes and domains.
“generalized psychomotor slowing [4, 5] can also impact performance across several cognitive processes and domains.”
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Pattern of brain atrophy in elderly patients with depression revealed by voxel-based morphometry
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Self-citation
- Authors
- Butters, M. A., Whyte, E. M., Nebes, R. D., Begley, A. E., Dew, M. A., Mulsant, B. H., Zmuda, M. D., Bhalla, R., Meltzer, C. C., Pollock, B. G., Reynolds, C. F., & Becker, J. T.
- Affiliations
- University of Pittsburgh (US)
- ORCID
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 2004-06-01
- Volume
- 61
- Issue
- 6
- Pages
- 587
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2119528561
- Semantic Scholar
- 3f2fbe984a12fcfafe2f9be9fe3d4421dc0cc085
- Cited by
- 622
- References
- 81
- Citations by year
- 2026: 15 · 2025: 24 · 2024: 21 · 2023: 21 · 2022: 18 · 2021: 35 · 2020: 38 · 2019: 32 · 2018: 29 · 2017: 35 · 2016: 37 · 2015: 33 · 2014: 41 · 2013: 38 · 2012: 32
- FWCI
- 10.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (AG 05-133, P50AG005133)
- National Institute of Mental Health (MH-01684, MH-52247, P30MH052247, MH 01077, K01MH001684, K24MH065416, MH-37869, MH-43832, MH 65416, K02MH001077, R01MH037869)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- geriatric depression, cognitive impairment, neuropsychological performance, processing speed, executive function, visuospatial ability, language skills, apolipoprotein E, anticholinergic agents, vascular disease, frontostriatal dysfunction, older adults
- MeSH terms
- Age Factors, Aged, Ambulatory Care, Cognition Disorders, Cross-Sectional Studies, Major Depressive Disorder, Educational Status, Female, Humans, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Risk Factors, Severity of Illness Index, Comorbidity, Age of Onset
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